Imagine someone arguing as follows: Driving an automobile can result in injury or death. Logically speaking, the only way to completely avoid this risk is to never drive an automobile. True, seatbelts have been shown to drastically reduce the risk of death and/or injury in the event of an accident, but not always. But in some instances -- particularly if they are used inappropriately, such as only wearing lap belts -- seatbelts may fail to protect. Therefore, to completely eliminate risk, individuals should be discouraged from driving automobiles altogether. Additionally, it is best not to inform people of the safety seatbelts can and do provide the vast majority of the time, or how to use them, given that such knowledge might actually encourage people to jeopardize their safety and take the risk of driving. In fact, we should consider not mentioning seatbelts at all, aside from their failure rates.
Is the above a logical approach to eliminating death and injury associated with car accidents? Or is it a foolish and dogmatic denial of the fact that many people will ultimately choose to drive automobiles despite the associated risks and, worse, would likely not know how to protect themselves by buckling up if the argument above were taken seriously?
Just as it is ridiculous to expect that only emphasizing the associated risks will keep all people from driving, attempting to prevent all teens from engaging in sexual activity is unlikely to have the desired effect. Purposeful omission of information about how teens can protect themselves (should they decide to engage in sexual activity) makes one wonder if the goal of such an approach is not, first and foremost, protection of health but adherence to a desired moral standard.
Despite the last few years of federally-funded "abstinence-only" sexual education programs, it has been shown that many adolescents are still engaging in some form of sexual activity. In fact, one study indicates that by age eighteen, 71% of U.S. youths have had vaginal intercourse. (1) Another showed that 25-50% of teens report having had oral sex, and a yet another showed that 10% of teens who declared themselves virgins have also had oral or anal sex. (2)(3)
Since their inception, abstinence-only curricula have been censured for being motivated less by science and more by ideology. In fact, they have been shown to distort scientific truths, to perpetuate gender roles and biases, and to selectively omit information that does not support particular faith-based doctrines.
And since, by law, these curricula are not permitted to include information on condom use or other means of birth control, other than their failure rates, it seems logical that those teens who do choose to be sexually active may be at increased risk of acquiring STDs or becoming pregnant. An eight-year-long joint study from Columbia and Yale Universities -- involving a nationally representative sample of 20,000 adolescents from twelve to eighteen years of age and published in the Journal of Adolescent Health -- has found alarming evidence to support precisely this hypothesis.
According to the data, 61% of teens who took abstinence pledges did not abide by them and engaged in vaginal intercourse before marriage. Pledgers who did abstain from vaginal intercourse were found to be more likely than non-pledgers to engage in other kinds of sexual activity that carry the risk of STD transmission, specifically oral and anal intercourse. More alarmingly, the pledgers engaging in non-vaginal intercourse were less likely than non-pledgers to use condoms during their sexual activities, and less likely to get tested for STDs. It may be because they were never informed about such protective measures, just as the person who hasn't been told the value of buckling up probably won't reach for the seatbelt. The findings correlate closely with previous data indicating that teens who take and abide by virginity pledges are just as likely to have STDs as their non-pledging peers.
Conservative critics have responded with claims that the Columbia/Yale study overlooks other important findings about teens who take abstinence pledges, namely that they have fewer pregnancies and out-of-wedlock births due to decreased tendencies towards vaginal intercourse. That's great, but they might have an STD that could have been prevented had they known of available protection. Other abstinence-only advocates have called the study "bogus," since the individuals involved must not have pledged "true abstinence" from sexual activity. Unfortunately, some curricula do a poor job of defining sexual activity.
Results of the Columbia/Yale study raise questions what possible scientific -- as opposed to "value-based" -- justification there might be for the abstinence-only approach. The above results emphasize the need to embrace comprehensive sexual education, which -- while highlighting the unarguably foolproof nature of total abstinence for preventing STDs and pregnancy -- also includes information vital to protecting teens who engage in sexual behavior. Other studies also suggest that comprehensive programs do not encourage sexual activity, as many feared they would.
Some pledgers and some non-pledgers will likely have sex. Arguing that abstinence-only education benefits the health of such teens is like arguing for the cessation of "buckle-up" campaigns as part of an effort to decrease the number of automobile-related deaths.
1. Alan Guttmacher Institute. Sex and America's Teenagers. New York: The Institute, 1994.
2. Newcomer S, Udry J. Oral sex in an adolescent population. Archives of Sexual Behavior 1985; 14:41-46.
3. Schuster MA, Bell RM, Kanouse DE. The sexual practices of adolescent virgins: genital sexual activities of high school students who have never had vaginal intercourse. American Journal of Public Health 1996; 86:1570-1576.
Aubrey Stimola is Assistant Director of Public Health at the American Council on Science and Health.